Autosomal Dominant Polycystic Kidney Disease and Hypertension are Associated with Left Ventricular Mass in a Gender-Dependent Manner

Pietrzak-Nowacka, Maria; Safranow, Krzysztof; Czechowska, Małgorzata; Dutkiewicz, Grażyna; Kornacewicz-Jach, Zdzisława; Ciechanowski, Kazimierz

doi:10.1159/000343419

Cited by 11 publications

(10 citation statements)

References 26 publications

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“…As mentioned earlier, our ADPKD patients have higher levels of LVM, even though they have similar arterial BP levels compared to the control group. This finding is supported by several other studies, and development of LVH in normotensive ADPKD patients may have caused by several reasons including; renin-angiotensin-aldosterone system activation, adrenergic stimulation, endothelial dysfunction and diastolic dysfunction (Ecder and Schrier 2009 ; Martinez-Vea et al 2000 ; Kocyigit et al 2014 ; Pietrzak-Nowacka et al 2012 ; Chapman et al 1997 ). In addition, preserved LVEF points to the presence of diastolic dysfunction.…”

Section: Discussionsupporting

confidence: 65%

Early atherosclerosis in normotensive patients with autosomal dominant polycystic kidney disease: the relation between epicardial adipose tissue thickness and carotid intima-media thickness

et al. 2016

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Epicardial adipose tissue thickness (EATT) is suggested as a novel marker of subclinical atherosclerosis. Despite increased carotid intima-media thickness (CIMT) in autosomal dominant polycystic kidney disease (ADPKD) patients, the extent of the relationship between CIMT and EATT is unknown. The main purpose of our study was to evaluate the relation between EATT and CIMT in normotensive ADPKD patients with well-preserved renal function. Fifty-five normotensive ADPKD patients with normal renal function and 50 healthy control subjects were included in the study. EATT and CIMT were measured by echocardiography in all subjects. Correlation between EATT and CIMT was evaluated in ADPKD patients, while multivariate linear regression analysis was performed to determine factors predicting EATT and CIMT. ADPKD patients had significantly higher levels CIMT [0.7 (0.4–1.2) vs. 0.5 (0.4–0.8) mm, p < 0.001] and EATT (6.8 ± 2.7 vs. 4.8 ± 1.2 mm, p < 0.001) as compared with control subjects. Significant positive correlation was found between EATT and CIMT (r = 0.58, p < 0.001). Higher CRP levels (OR 54.7, 95 % CI 37.44–72.01, p < 0.001) and having ADPKD (OR 10.2, 95 % CI 2.53–17.86, p = 0.01) were the only independent factors associated with a higher EATT. A higher age (OR 0.35, 95 % CI −0.02 to 0.71, p = 0.06) tended to be independently associated with a higher EATT. In conclusion, our findings suggest that EATT, being simply measured by echocardiography and correlated with CIMT, can be used to detect subclinical atherosclerosis in normotensive ADPKD patients.

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Section: Discussionsupporting

confidence: 65%

Early atherosclerosis in normotensive patients with autosomal dominant polycystic kidney disease: the relation between epicardial adipose tissue thickness and carotid intima-media thickness

et al. 2016

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“…When analyzing the comorbidities arterial hypertension and hypercholesteremia, a significant difference was only found for arterial hypertension for both IVSd and aortic root diameter in the ADPKD cohort. These findings regarding arterial hypertension are consistent with a previous report by Pietrzak-Nowacka et al , 32 who discovered an increase in IVSd and aortic root diameter in hypertensive patients with ADPKD compared with normotensive patients with ADPKD. Also, Mayo classes 1C–1E showed a larger IVSd than Mayo classes 1A–1B, again indicating an association with disease severity.…”

Section: Discussionsupporting

confidence: 93%

Cardiac Manifestations in Patients with Autosomal Dominant Polycystic Kidney Disease (ADPKD): A Single-Center Study

et al. 2022

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Background: ADPKD is the most common monogenetic kidney disease and results in kidney failure in over 75% of affected individuals. As a systemic disorder, ADPKD is associated with a variety of extrarenal manifestations affecting the majority of patients including cardiac manifestations. We characterized the cardiac involvement in ADPKD patients from the German AD(H)PKD registry and compared them to kidney donor candidates as controls. Methods: In this single-center cohort study, we evaluated 141 ADPKD (44.17 ± 11.23 years) patients from the German AD(H)PKD registry and 60 kidney donor candidates (55.08 ± 10.21 years). All patients underwent clinical examination, abdominal MRI, and transthoracic echocardiography. Results: 65% of ADPKD patients showed hypertrophy of the left ventricle (as defined by an end-diastolic left ventricular septal wall thickness (IVSd) greater than 10mm) compared to 55% in control patients. Mitral regurgitation was the most common finding among 53.57 % of ADPKD patients who exhibited valvular dysfunction, albeit mild in the majority of patients. Interestingly, left ventricular ejection fraction (LV-EF) differed significantly between both groups with higher values in ADPKD patients (63.53±6.38% vs. 60.21±5.72%), while other parameters including IVSd, left ventricular end-diastolic diameter (LVEDD), tricuspid annular plane systolic excursion (TAPSE) and pressure gradients across the aortic and tricuspid valve were similar between groups. Correlations of echocardiographic parameters with markers of disease progression revealed statistically significant associations for aortic root diameter (p = 0.014), the pressure gradient across the aortic valve (AV dPmax) (p = 0.0003) and left ventricular septal wall thickness (IVSd) (p = 0.0001), indicating that rapid kidney disease progression may also be associated with cardiac findings. Conclusion: Cardiovascular abnormalities are prevalent in ADPKD patients. Considering the importance of cardiovascular disease for outcome in CKD, early management and possibly prevention are important goals of any treatment scheme. Consequently, echocardiography should be offered to all ADPKD patients in routine management.

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“…It is of note that our previous study concerning myocardial hypertrophy in the same group of ADPKD patients showed that left ventricular mass index was significantly increased only in females but not in males. 25 We showed that kidney length and cyst diameter correlated positively with age in patients with ADPKD. Bivariate analysis with age and gender as independent variables showed that older age was a significant predictor of higher mean kidney length and mean cyst diameter.…”

Section: Discussionmentioning

confidence: 73%

“…14,15,25 However, in routine clinical practice ultrasonography is used because of lower costs and availability. 35,36 Our study with the use of ultrasound methods showed that mean kidney length and mean cyst diameter in patients with ADPKD might be good predictors of both excretory and metabolic kidney function.…”

Section: Discussionmentioning

confidence: 99%

Association of kidney and cysts dimensions with anthropometric and biochemical parameters in patients with ADPKD

Pietrzak-Nowacka¹,

Safranow

Palacz³

et al. 2015

Renal Failure

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The aim of the study was to evaluate an association between kidney and cyst dimensions and anthropometric, clinical and biochemical parameters of autosomal dominant polycystic kidney disease (ADPKD) patients. Forty-nine adults, ADPKD-diagnosed patients aged 36 ± 11 years, and 50 healthy controls were included in the study. Oral glucose tolerance test (OGTT with 75 g of glucose) was performed and venous blood was collected to measure biochemical parameters and various ion concentrations. Ultrasound abdominal examinations were performed with special emphasis on kidney and cysts parameters. In the ADPKD group, mean kidney length correlated positively with age, systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting glucose and glucose and C-peptide concentrations after 120 min of glucose intake and negatively with Mg(2+) concentration and glomerular filtration rate (eGFR). Multivariate analyses adjusted for age and gender showed that higher mean kidney length and maximal cyst diameter were significant predictors of higher SBP (p = 0.034 and 0.046, respectively) and DBP (p = 0.024 and 0.034, respectively), higher maximal cyst diameter was a significant predictor of higher OGTT 2-h C-peptide concentration (p = 0.033), higher mean cyst diameter was a significant predictor of lower eGFR (p = 0.039) and higher mean kidney length was a significant predictor of lower serum magnesium concentration (p = 0.043). In the ADPKD patients with normal GFR, mean kidney length and mean cyst diameter measured by ultrasonography are associated negatively with GFR and positively with blood pressure. Higher mean kidney length and cyst diameter might be indicators of disorders of glucose and magnesium metabolism which precede renal failure in patients with ADPKD.

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Autosomal Dominant Polycystic Kidney Disease and Hypertension are Associated with Left Ventricular Mass in a Gender-Dependent Manner

Cited by 11 publications

References 26 publications

Early atherosclerosis in normotensive patients with autosomal dominant polycystic kidney disease: the relation between epicardial adipose tissue thickness and carotid intima-media thickness

Early atherosclerosis in normotensive patients with autosomal dominant polycystic kidney disease: the relation between epicardial adipose tissue thickness and carotid intima-media thickness

Cardiac Manifestations in Patients with Autosomal Dominant Polycystic Kidney Disease (ADPKD): A Single-Center Study

Association of kidney and cysts dimensions with anthropometric and biochemical parameters in patients with ADPKD

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